MSK Examination - Hip

Question 1

What pos. should patient be in?

Answer 1

Flat as possible

Question 2

Look.

Answer 2

Any deformity, the symmetry
Scars, swellings
Muscle Wasting
Leg length discrepancy

Question 3

Feel.

Answer 3

Feel for temp and tenderness over greater trochanter
Apparant leg length - xiphisternum to medial malleolus
True leg length - ant. sup. illiac spine. to medial malleolus

Question 4

List the movements you do.

Answer 4

Flexion - bring knee up to head
Rotation - with hip and knee at 90* internally and externally rotate the leg and compare sides
Abduction - put your hand on the opposite ASIS and abduct the leg til the pelvis starts to move (45*)
Adduction - Place hand on same side ASIS and lift the legend cross over the other leg medially.

Then do thomas’ and trendelenburg’s test

Question 5

Desc. Thomas’s test and what its looking for?

Answer 5

A fixed flexion deformity

Lie patient supine
Place one hand under patients spine in lumbar region
Fully flex the hip until you feel the lordosis flatten and look at the other leg, if it raises then theres a fixed flexion deformity

Question 6

Describe trendelenburg’s test and what its assessing for?

Answer 6

Looking for weak or paralysed abductor muscles of the hip

Stand patient in front of and facing a mirror
Stand behind patient with hands on iliac crests
Ask patient to flex only the knee to pull the foot off the ground, do NOT let them flex the hip
A positive test is when the pelvis dips on the side of the leg being lifted